Summary of findings 3. Myofunctional therapy compared to CPAP for obstructive sleep apnoea.
| Myofunctional therapy compared to CPAP for obstructive sleep apnoea | ||||||
| Patient or population: obstructive sleep apnoea Setting: Outpatient Intervention: Myofunctional therapy Comparison: CPAP | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with CPAP | Risk with Myofunctional therapy | |||||
| Daytime sleepiness (ESS): endpoint score. Follow‐up: 3 months. | The mean ESS endpoint score was 7.2 | MD 0.3 higher (1.65 lower to 2.25 higher) | ‐ | 54 (1 RCT) | ⊕⊕⊝⊝ LOW1 2 | May result in little to no difference in daytime sleepiness. Scores from 0 to 24. Lower scores denote lower daytime sleepiness. MCID 3 points. |
| AHI: endpoint score. Follow‐up: 3 months. | The mean AHI endpoint score was 4.3 events/hour | MD 9.6 events/hour higher (2.46 higher to 16.74 higher) | ‐ | 54 (1 RCT) | ⊕⊕⊝⊝ LOW1 2 | May increase AHI. Events per hour. Lower scores better. MCID 5 points. |
| Snoring frequency: endpoint score. Follow‐up: 3 months. | The mean snoring frequency endpoint score was 3.1 | MD 1.8 higher (0.16 lower to 3.76 higher) | ‐ | 54 (1 RCT) | ⊕⊕⊝⊝ LOW1 2 | May result in little to no difference in snoring frequency. Subjective VAS. Lower scores better. MCID: not available. |
| Snoring intensity: endpoint score. Follow‐up: 3 months. | The mean snoring intensity endpoint score was 2.6 | MD 1.7 higher (0.02 lower to 3.42 higher) | ‐ | 54 (1 RCT) | ⊕⊕⊝⊝ LOW1 2 | May result in little to no difference in snoring intensity. Subjective VAS. Lower scores better. MCID: not available. |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). AHI: apnoea hypopnoea index; CI: Confidence interval; ESS: Epworth sleepiness scale; MD: mean difference; MCID: Minimal Clinically Important Diference; PSQI: Pittsburgh Sleep Quality Index; VAS: Visual Analog Scale | ||||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
1 Downgraded one point for incomplete outcome data
2 Downgraded one point for imprecision